Case Report: Toxic tubulointerstitial nephropathy with lipofuscin deposition - the potential cause of occupational Bisphenol-A exposition

Abstract

This case study delves into the link, between exposure to Bisphenol A (BPA) and kidney issues filling a gap in human focused research found in studies. The individual, a 72-year man with a history of BPA exposure in a plastics manufacturing facility experienced a gradual decline in kidney function over 18 months. Medical tests showed kidney disease with a buildup of lipofuscin in renal tubular cells upon examination. This discovery suggests a connection between BPA exposure and kidney damage underscoring the need for investigation. The lack of human based evidence highlights the importance of research to understand the toxic effects of BPA on the kidneys. In addition, to its implications this case emphasizes the importance of improving safety protocols and raising awareness among healthcare professionals in relevant work environments to reduce potential health risks associated with BPA exposure.

Keywords: bisphenol A (BPA) exposure; chronic kidney disease; lipofuscin accumulation; nephrotoxicity; workplace safety.

FIGURE 1

Presents a comparative view with (A) showcasing a routine periodic acid-Schiff (PAS) stain at ×200 magnification and (B) displaying a hematoxylin and eosin (HE) stain at ×400 magnification with intraepithelial lipofuscin brown pigmentation (black arrows). The special stains like: Masson Fontana (C), Touluidine blue (D), Oil Red-O (E) and Sudan black (F) for lipid content evaluation displayed positive staining (200x, black arrows). Other possible brownish pigments like copper with Rhodamin stain (G), bile with Fouchet stain (H) and iron with Prussian Blue stain (I) all yielding negative outcomes (200x).

FIGURE 2

Presents an immunofluorescence examination, showcasing a control slide with noticeable green autofluorescent cytoplasmic granules in the tubular epithelial cells (200x, white arrow).

FIGURE 3

Presents electron microscopic ultrastructural images capturing the tubular epithelial cell lipofuscin granules. At 15,000x magnification (A) and further magnified at 50,000x (B), these detailed images provide a closer look at the cellular structures affected by lipofuscin accumulation.